糜酶和传统心血管危险因素的交互作用与糖尿病前期关系的研究  

Relationship of Prediabetic State to Interaction between Chymase and Traditional Cardiovascular Risk Factors

作　　者：王巧玲[1] 沈旭慧[1] 姚行[2] 徐玲芬[3] 邱蔚[4] 叶国芬 王珍[6] 

机构地区：[1]湖州师范学院医学院护理学院护理医学系,浙江省湖州市313000 [2]湖州市中心医院党委办公室 [3]湖州市中心医院护理部 [4]湖州市中心医院内分泌科 [5]湖州市爱山街道社区卫生服务中心 [6]湖州师范学院医学院护理学院临床医学系,浙江省湖州市313000

出　　处：《中国全科医学》2013年第35期4140-4143,4147,共5页Chinese General Practice

基　　金：湖州市科技计划攻关项目(2012GS02)

摘　　要：目的探讨糜酶和传统心血管危险因素的交互作用与糖尿病前期(PDS)的关系,为糖尿病(DM)的机制研究提供依据。方法 2009年7—9月采用简单随机抽样方法抽取我市社区1 197例55～75岁的常住居民进行空腹血糖(FBG)与餐后2 h血糖检测,根据结果再随机抽取71例糖耐量正常者(NG组)和189例PDS者(PDS组)进行生化及免疫指标的检测与比较,并对糜酶和传统心血管危险因素的交互作用与PDS的关系进行分析。结果 (1)PDS组的FBG、餐后2 h血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)、收缩压(SBP)、腰围、腰臀比均高于NG组,而PDS组的β细胞敏感性指数(HOMA-β)低于NG组(P<0.05)。(2)单因素Logistic回归分析显示:年龄(60～64岁)、高血压、中心性肥胖(是)、胰岛素升高(中)、HOMA-β降低(>85.96)和HOMA-IR升高(中、高)与PDS呈正相关,且不同的血压、HOMA-β和HOMA-IR存在线性趋势。多因素Logistic回归分析显示:中心性肥胖(是)、胰岛素升高(中)、HOMA-β降低(>85.96)和HOMA-IR升高(中、高)与PDS呈正相关,且不同的年龄、血压、体质指数(BMI)、HOMA-β、HOMA-IR和糜酶水平存在线性趋势。(3)相关性分析显示:糜酶<21.16μg/ml且BMI≥24 kg/m2、糜酶≥21.16μg/ml且中心性肥胖、糜酶≥21.16μg/ml且TC≥5.20μg/ml、糜酶≥21.16μg/ml且胰岛素≥6.00 mU/L、糜酶≥21.16μg/ml且HOMA-β<57.82、糜酶<21.16μg/ml且HOMA-IR≥1.58、糜酶≥21.16μg/ml且HOMA-IR≥1.58的交互作用与PDS存在相关性。结论传统心血管因素与PDS存在相关性,糜酶和传统心血管危险因素的交互作用与PDS存在相关性,糖尿病的一些危险因素在PDS就已存在。Objective To explore the relationship of prediabetic state （PDS） to the interaction between chymase and traditional cardiovascular risk factors, to provide basis for research of diabetes mellitus （DM） mechanism. Methods Fasting blood glucose （FBG）, 2h postprandial blood glucose （2h PBG） were determined in 1 197 residents aged 55 -75 years in urban communities from July to September 2009. Based on the results, 71 subjects with normal carbohydrate tolerance （NG group） and 189 PDS subjects （PDS group） were selected to have biochemical and immune parameters detection. The relationship of PDS to the interaction between chymase and traditional cardiovascular risk factors were analyzed. Results FBG, 2h PBG, fast- ing insulin, insulin resistance index （ HOMA - IR） , systolic blood pressure （SBP） , waist circumference （WC） , waist - hip ratio （WHR） were higher in PDS group than in NG group, 13 cell sensitivity index （ HOMA - β） lower （ P 〈 0.05 ）. By uni- variate Logistic regression analysis, age （ 60 - 64 years old）, hypertension, central obesity, increased insulin （ moderate）, decreased HOMA -β and increased HOMA - IR （ moderate or high） were positively correlated with PDS, and there was a linear trend between chymase level and varying ages, pressure, BMI, HOMA - 13, HOMA - IR. By correlation analysis, the interac- tions of chymase 〈21.16 μg/ml and BMI ≥24 kg/m2, chymase 〉121.16 μg/ml and central obesity, chymase 〉121.16 μg/ml and TC≥5.20 mmol/L, chymase ≥ 21.16 μg/ml and insulin ≥ 6. 00 mU/L, chymase ≥21.16 μg/ml and HOMA- 13 〈57. 82, chymase 〈21.16μg/ml and HOMA -IR ≥1.58, chymase I〉21.16 μg/ml and HOMA -IR≥ 1.58 were correlated with PDS. Conclusion There is a correlation between traditional cardiovascular risk factors and PDS, and between PDS and the interaction between chymase and traditional cardiovascular risk factors. Some risk factors of DM exist in PDS.

关 键 词：糜酶 心血管系统 危险因素 糖尿病前期 交互作用 相关性 

分 类 号：R587.1[医药卫生—内分泌]